title: Immunological screening for tumor cells in serous body fluids has added value with the CELL-DYN Sapphire.
abstract: BACKGROUND
  Conventional cytological examination has limited sensitivity for detecting tumor cells in serous body cavity effusions and therefore, adjuvant techniques are necessary for a reliable diagnosis. Flow cytometry has proven benefit in these circumstances. The aim of our study was to explore the feasibility of CELL-DYN Sapphire, an advanced hematology analyzer with flow cytometric capabilities, for detecting tumor cells in serous body fluids, using CD326 monoclonal antibodies, which are directed against the epithelial marker EpCAM.
  
  
  METHODS
  One hundred and five serous fluids (39 peritoneal and 66 pleural effusions) were analyzed by the CELL-DYN Sapphire using monoclonal antibody combinations CD3/CD19 and CD45/CD326. Of all samples a cytospin preparation was made and microscopically examined; the pathology findings served as a reference.
  
  
  RESULTS
  Using a threshold of 1% CD326+ cells, CELL-DYN Sapphire identified nine out of 12 cases with tumor cells in the serous effusions (sensitivity 75%), whereas routine cytology found eight cases (sensitivity 67%). The combination of immunophenotyping and cytology identified all 12 cases with tumor cells in the effusion fluid (sensitivity 100%). The specificities were 92% and 100%, respectively.
  
  
  CONCLUSIONS
  We demonstrated that it is feasible to run an immunophenotypic assay on CELL-DYN Sapphire for detecting tumor cells in serous body fluids. In addition, this study confirmed that a combination of conventional cytology and flow cytometry had a very high diagnostic yield in cases of carcinomatous effusions.
authors.forename: Jeffrey F W
authors.initials: JF
authors.lastname: Keuren
authors.forename: Johannes J M L
authors.initials: JJ
authors.lastname: Hoffmann
authors.forename: Mathie P G
authors.initials: MP
authors.lastname: Leers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000276:immunology; D000951:Antigens, Neoplasm / Q000276:immunology / Q000378:metabolism; D001202:Ascitic Fluid / Q000166:cytology*; D001331:Automation; D015815:Cell Adhesion Molecules / Q000276:immunology / Q000378:metabolism; D000071858:Epithelial Cell Adhesion Molecule; D004847:Epithelial Cells / Q000166:cytology / Q000378:metabolism; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000473:pathology; D009360:Neoplastic Cells, Circulating / Q000378:metabolism; D035422:Pleural Cavity / Q000166:cytology*; D010996:Pleural Effusion / Q000378:metabolism / Q000473:pathology; D012680:Sensitivity and Specificity; D012704:Serous Membrane / Q000166:cytology / Q000378:metabolism / Q000473:pathology
chemical_list: D000911:Antibodies, Monoclonal; D000951:Antigens, Neoplasm; D015815:Cell Adhesion Molecules; C499379:EPCAM protein, human; D000071858:Epithelial Cell Adhesion Molecule